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目的:总结前交通动脉瘤经血管内栓塞治疗的经验和体会。方法:回顾性分析我院经血管内栓塞治疗的189例前交通动脉瘤的临床资料,造影随访3~24个月。结果:成功栓塞前交通动脉瘤189例,致密栓塞161例;瘤体少量显影12例;瘤颈少量残留16例。术中并发脑血管痉挛12例;血栓形成6例;术中破裂3例,2例因出血死亡。单纯弹簧圈栓塞治疗146例,支架辅助弹簧圈栓塞治疗宽颈动脉瘤43例。术后92例造影随访3~24个月均无再出血,14例复发,23例支架辅助治疗患者随访中均未见复发及再出血。结论:血管内栓塞治疗前交通动脉瘤疗效可靠。支架辅助弹簧圈栓塞可降低宽颈前交通动脉瘤的复发率。早期治疗,合理应用各种辅助技术,正确处理术中并发症可有效提高治疗质量并减少预后不良。
OBJECTIVE: To summarize the experience and experience of endovascular embolization of anterior communicating aneurysms. Methods: The clinical data of 189 cases of anterior communicating artery aneurysm treated by endovascular embolization in our hospital were retrospectively analyzed. The follow-up was 3 to 24 months. Results: 189 cases of arterial aneurysm before embolization, 161 cases of dense embolism, 12 cases of aneurysm developing in a small amount and 16 cases of tumor neck remaining in a small amount. Intraoperative cerebral vasospasm in 12 cases; thrombosis in 6 cases; 3 cases of intraoperative rupture, 2 died of bleeding. Simple coil embolization in 146 cases, stent-assisted coil embolization in the treatment of 43 cases of wide-necked aneurysms. No recurrence was found in 92 cases with follow-up of 3 to 24 months after operation, and 14 cases relapsed. No recurrence and rebleeding occurred in 23 cases of follow-up of stent-assisted therapy. Conclusion: Coronary artery embolization before treatment is reliable. Stent assisted coil embolization can reduce the recurrence rate of wide-necked anterior communicating aneurysms. Early treatment, rational use of various assistive technologies, the correct treatment of intraoperative complications can effectively improve the quality of treatment and reduce the prognosis.